Implications Counselling Before Surrogacy & Donation 

By Michelle Flowerday, Toronto-based Fertility Lawyer, Founder, Flowerday Fertility Law

If you are considering surrogacy, egg donation, sperm donation or embryo donation, your fertility clinic will almost certainly recommend and, in most cases, require you to complete implications counselling before treatment begins.

For many people, hearing the word “counselling” immediately raises concerns.

“Is this a psychological assessment?”

“Can I fail?”

The short answer is no.

Implications counselling is not intended to be a psychological assessment. Rather, it is an opportunity to understand the emotional, ethical and practical implications of your third-party reproduction journey before treatment begins.

After practicing exclusively in fertility law for more than 16 years, one thing I have learned is that clients often approach counselling with apprehension but leave feeling informed, reassured and grateful they had the experience.

In this blog, I’ll explain what implications counselling is, why Canadian fertility clinics recommend it, what to expect during the process, and how it fits into your legal journey.

Understanding Implications Counselling Before Surrogacy, Egg, Sperm, and Embryo Donation in Canada 

• Implications counselling is not a psychological assessment. 
• It helps intended parents, surrogates and donors understand the emotional, ethical and practical implications of third-party reproduction. 
• Although Canadian legislation does not expressly require counselling, virtually every Canadian fertility clinic recommends, and most require it before treatment begins. 
• The ideal time to complete counselling is before medical treatment begins and, whenever possible, before legal agreements are finalized. 
• Working with an experienced fertility counsellor can help everyone begin the journey with realistic expectations and greater confidence.

What Is Implications Counselling For Surrogacy and Donor Conception?

Implications counselling is a specialized form of counselling designed specifically for people participating in third-party reproduction.

This includes:

• Intended parents pursuing surrogacy 
• Intended parents using donated eggs, sperm, or embryos 
• Gestational surrogates
• Traditional surrogates
• Egg donors 
• Sperm donors 
• Embryo donors 

Unlike traditional therapy, implications counselling focuses on helping participants understand the unique emotional, ethical, relational, and practical issues that may arise throughout their journey.

Rather than determining whether someone is “fit” to participate, the counsellor encourages thoughtful conversations about expectations, possible scenarios, communication, future relationships, and the realities of building a family through third-party reproduction.

The objective is simple: to help all parties move forward with a clear understanding of the journey ahead.

Is Implications Counselling Legally Required in Canada?

This is an area where there is often confusion.

Neither the Assisted Human Reproduction Act nor the Assisted Human Reproduction (Section 8 Consent) Regulations expressly require implications counselling.

Instead, implications counselling has become the accepted standard of care through the professional guidelines followed by Canadian fertility clinics, particularly those developed jointly by the Canadian Fertility and Andrology Society (CFAS) and the Canadian Association of Reproductive Counsellors (CARC).

As a result, while the legal obligation arises through clinic policies and professional standards rather than legislation itself, virtually every Canadian fertility clinic recommends and most require participants in a third-party reproduction journey to complete implications counselling before treatment proceeds.

Perhaps the greatest misconception surrounding implications counselling is that participants are being evaluated to determine whether they are psychologically suitable to become parents, surrogates, or donors.

That is not its purpose. There is no examination. There is no score. There is no checklist that participants either pass or fail.

Instead, implications counselling is intended to help participants better understand the emotional, relational, and practical implications of the journey they are about to undertake.

However, counsellors also have professional responsibilities and on rare occasions, a counselling session may identify significant concerns. For example, evidence of coercion, unrealistic expectations, a lack of informed understanding, or unresolved issues that could meaningfully affect the arrangement. When this occurs, the counsellor may recommend additional counselling, further discussion, or delaying treatment until those concerns have been addressed.

These situations are uncommon.

The vast majority of participants complete counselling and move forward feeling more informed, more confident and better prepared for the journey ahead.

Third-party reproduction creates relationships unlike almost any other form of family building.

If you are carrying a pregnancy for another family, donating eggs, sperm, or embryos, or growing your own family with the help of a donor or surrogate, there are conversations that deserve thoughtful attention before treatment begins.

Implications counselling helps participants:

• explore expectations 
• improve communication 
• establish healthy boundaries 
• discuss medical decision-making 
• prepare for difficult or unexpected situations 
• consider disclosure to future children 
• discuss future relationships between the parties 
• understand the emotional aspects of the journey 

One thing I have learned over the years is that assumptions are one of the greatest sources of conflict in any third-party reproduction journey. Everyone may believe they are on the same page until they are asked thoughtful questions by an experienced counsellor. Those conversations often uncover expectations that simply had not been discussed before.

Having those conversations early can make all the difference.

When Should You Complete Implications Counselling?

The ideal time to complete implications counselling is before any medical treatment begins. This gives all parties the opportunity to ask questions, reflect on important issues and consider the implications of the arrangement before irreversible medical steps are taken.

Whenever possible, I also recommend that counselling take place before the legal agreements are finalized.

From a practical perspective, this benefits all parties.

Legal agreements are designed to reflect the intentions, expectations, and understandings of the parties. Implications counselling often encourages discussions that participants had not previously considered and may identify issues that should be addressed within the legal agreement itself.

In my practice, I have found that the strongest legal agreements are built on conversations that have already taken place not conversations that still need to happen. When counselling comes first, the legal agreement can accurately reflect the parties’ intentions rather than becoming the place where important issues are first discovered.

Although the exact timing may vary depending on the clinic and the circumstances of the journey, completing implications counselling before legal agreements are finalized and before treatment begins is generally considered best practice.

It is common for intended parents, surrogates, and donors to wonder whether counselling or legal advice should come first.

Whenever possible, I recommend completing implications counselling before finalizing legal agreements. Doing so often leads to more informed discussions and allows the legal agreement to accurately reflect the expectations and intentions that have already been explored during counselling.

Clients sometimes ask me:

“If we’re all getting along so well, do we really need both counselling and lawyers?”

My answer is always the same.

The best time to have important conversations is when all parties are aligned.

Counselling and legal advice are not there because we expect problems.

They are there to help prevent them. 

As your fertility lawyer, my role is to explain:

• your legal rights and responsibilities 
• the terms of your agreement 
• how Canadian fertility law applies to your circumstances 
• what happens if unexpected situations arise 

Your counsellor serves a different, and equally important, role.

They help participants explore expectations, communication, relationships, and the emotional aspects of the journey.

Together, these two processes create a strong foundation for informed decision-making and a successful third-party reproduction arrangement.

Not every mental health professional specializes in fertility or third-party reproduction.

Implications counselling is typically provided by a registered social worker, psychologist, psychotherapist, or other regulated mental health professional with specialized training and experience in reproductive counselling and third-party reproduction.

While many people already have a trusted therapist, it is important to recognize that not every mental health professional has experience with the unique legal, medical, ethical and emotional issues that can arise during a surrogacy or donor conception journey.

Experienced fertility counsellors understand the complexities surrounding:

• gestational surrogacy 
• egg donation 
• sperm donation 
• embryo donation 
• donor-conceived families 
• disclosure to donor-conceived children 
• communication and expectations between the parties 
• future contact and ongoing relationships 
• cross-border fertility arrangements 

Because these journeys are unlike almost any other form of family building, working with a counsellor who regularly provides implications counselling can make a meaningful difference. They know the questions to ask, the issues to explore, and the conversations that can help participants better understand the journey they are about to undertake.

Choosing the right counsellor is not simply about meeting a clinic requirement, rather it is about having meaningful conversations with someone who understands the unique dynamics of third-party reproduction.

At Flowerday Fertility Law, we regularly work with experienced fertility counsellors across Canada and are happy to recommend professionals who are highly respected within the fertility community and experienced in supporting intended parents, gestational surrogates, egg donors, sperm donors and embryo donors.

Book A Free Consultation with Michelle Flowerday

At Flowerday Fertility Law, we advise intended parents, surrogates and donors throughout Ontario and across Canada, and regularly work with experienced fertility counsellors who specialize in third-party reproduction.

If you are an intended parent, surrogate, egg donor, sperm donor, or embryo donor, we are happy to connect you with professionals who have extensive experience supporting individuals and families through these unique journeys.

We also coordinate closely with fertility clinics and counsellors to make sure that counselling, legal advice and medical treatment occur in the appropriate sequence, allowing your journey to progress as smoothly as possible.

One of the things I enjoy most about practicing fertility law is seeing the incredible generosity and trust that make these journeys possible. Whether someone is carrying a pregnancy for another family, donating eggs or embryos, or pursuing parenthood with the help of a donor or surrogate, every journey begins with thoughtful preparation.

Implications counselling is an important part of that preparation.

If you have questions about the legal aspects of surrogacy, egg donation, sperm donation, or embryo donation (or if you would like a referral to an experienced fertility counsellor) we would be delighted to help.

Book A Free Consultation with Michelle Flowerday

Is implications counselling the same as therapy?

No. While both are provided by qualified mental health professionals, implications counselling is educational and preparatory. It focuses specifically on the emotional, ethical and relational implications of third-party reproduction rather than treating a mental health condition.

Can I fail implications counselling?

There is no formal pass or fail. Most participants complete counselling and proceed with treatment. In rare cases, if significant concerns are identified, a counsellor may recommend additional counselling or delaying treatment until those concerns have been addressed.

Who should complete implications counselling – surrogates, donors, or intended parents?

Depending on the arrangement and your fertility clinic’s policies, implications counselling may be recommended or required for intended parents, gestational surrogates, egg donors, sperm donors and embryo donors.

Can counselling be completed virtually?

Yes. Many experienced fertility counsellors offer secure virtual appointments, making counselling accessible regardless of where you live in Canada.

Is implications counselling confidential?

Generally, yes. Counselling sessions are confidential, although counsellors may provide confirmation to your fertility clinic that the counselling has been completed and, in rare circumstances, may communicate concerns where ethically or professionally required. If you have questions about confidentiality, ask your counsellor to explain how information will be handled before your session begins.

How long does implications counselling take?

Most implications counselling sessions last between 60 and 90 minutes, although this varies depending on the circumstances and the counsellor.

Who pays for implications counselling?

In most third-party reproduction journeys, the intended parent(s) are responsible for paying the cost of implications counselling for all participants. However, this may vary depending on the arrangement and the parties’ agreement.

Can I choose my own fertility counsellor?

Usually, yes. However, your fertility clinic may have specific requirements or a list of fertility counsellors in Canada who have experience in third-party reproduction. It is always best to confirm your clinic’s expectations before booking an appointment.

Do all Canadian fertility clinics require implications counselling?

Although implications counselling is not expressly required by the Assisted Human Reproduction Act, virtually every Canadian fertility clinic recommends, and most require it before treatment proceeds.

Does counselling happen before or after meeting with a fertility lawyer?

Ideally, implications counselling should take place before legal agreements are finalized and before medical treatment begins. This allows the issues discussed during counselling to be reflected in the legal agreement where appropriate.

What is the difference between implications counselling and a psychological assessment?

Implications counselling is educational and preparatory. It focuses on helping participants understand the emotional, ethical and practical implications of third-party reproduction. A psychological assessment, by contrast, is designed to evaluate an individual’s mental health or psychological functioning. Although counsellors have professional responsibilities and may identify concerns that warrant further discussion, implications counselling is not intended to function as a psychological evaluation.

About Michelle Flowerday, Toronto Fertility Lawyer

Michelle Flowerday is the founder of Flowerday Fertility Law, a Canadian law firm dedicated exclusively to fertility law and third-party reproduction. For more than 16 years, she has advised intended parents, surrogates, egg donors, sperm donors and embryo donors throughout Ontario and across Canada. Michelle is passionate about helping families navigate the legal aspects of assisted reproduction with clarity, compassion and confidence.

Sources

• Assisted Human Reproduction Act, S.C. 2004, c. 2. 
• Assisted Human Reproduction (Section 8 Consent) Regulations, SOR/2007-137. 
• Canadian Fertility and Andrology Society (CFAS). 
• Canadian Association of Reproductive Counsellors (CARC), Guidelines for Psychosocial Counselling in Third-Party Reproduction.